2015 ISAKOS Biennial Congress ePoster #1307

Two-Dimensional Motion Analysis to Determine Risk Factors for Non-Contact Anterior Cruciate Ligament Injury

Hitoaki Numata, MD, Kanazawa, Ishikawa JAPAN
Junsuke Nakase, MD, PhD, Kanazawa, Ishikawa JAPAN
Takeshi Oshima, MD, PhD, Sydney, NSW AUSTRALIA
Yosuke Shima, MD, PhD, Kanazawa, Ishikawa JAPAN
Katsuhiko Kitaoka, MD, Kanazawa, Ishikawa JAPAN
Hiroyuki Tsuchiya, Kanazawa, Ishikawa JAPAN

Kanazawa Univercity, Kanazawa, Ishikawa, JAPAN

FDA Status Cleared

Summary: We prospectively screened 291 female athletes using two-dimensional motion analysis during the single leg drop jump test. Twenty-seven knees with a non-contact anterior cruciate ligament (ACL) injury were compared with 27 knees without ACL injury. We found that dynamic knee valgus might be a risk factor for non-contact ACL injury using two-dimensional motion analysis.

Rate:

Abstract:

Objectives:
A higher rate of anterior cruciate ligament (ACL) injuries is found in female athletes participating in high-risk sports than in male athletes. Numerous studies have shown that dynamic knee valgus was a risk factor for non-contact ACL injury using three-dimensional motion analysis technique. However, refined motion analysis in common sports field is difficult because of the facilities, technique, and time required. The purpose of this study was to evaluate risk factors for non-contact ACL injury using two-dimensional (2D) motion analysis during single leg drop jumping.

Methods

In this prospective controlled cohort study, we screened 291 female high school basketball and handball players during the single leg drop jump test using 2D biomechanical analysis at the start of high school. During the 3-year follow-up period, 28 athletes with 30 involved knees had a confirmed ACL rupture; 3 had a contact ACL injury and 27 had a non-contact ACL injury. Twenty-seven controls with no ACL injury were compared with the 27 non-contact ACL tears. Height and weight were similar in the 2 groups. Subjects performed a single leg drop jump from a 30-cm-high box, which was recorded using a 2D video camera in the frontal plane. We measured the distance suggested to quantify dynamic knee valgus, from the hallux to the point where the line connecting the center of the patella and anterior superior iliac spine intersects the floor, at two points—when the top of the hallux connected the ground and the knee was most valgus. The distance was graded as positive if the point was located inward from the hallux. The Student’s t-test was used to evaluate differences in the distance between the injured and uninjured groups. The minimum level of significance was set at P < 0.05.

Results

At contact of the hallux with the ground, the distance was 2.1±2.4 cm in the injured group and 0.4±2.2 cm in the control group. At maximum knee valgus, the distance was 8.3±4.3 cm in the injured group and 5.1±4.1 cm in the control group.
The distance in the injured group was significantly higher than that in the control group at both points. (P = 0.006 and P = 0.007, respectively)

Conclusions

In the current study, neuromuscular control and knee joint load were prospectively examined relative to ACL injury status, considering increased valgus motion and valgus moments at the knee joint during the impact phase of jump-landing tasks as key predictors of increased risk for ACL injury in female athletes. The results indicated that dynamic knee valgus might be a risk factor for non-contact ACL injury and that 2D motion analysis during the single leg drop jump test might be useful for screening.